NPIMap

Individual provider Active NPI

Jasmyn Miller, MD

  • Internal Medicine Physician
  • Buffalo, NY
National Provider Identifier
1063079648
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
316025 Issued in NY
Practice address
900 Hertel Ave
Buffalo, NY 14216-2611
Phone
(716) 871-1571
NPI assigned
May 20, 2019
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 316025 NY Primary

Addresses

Primary practice location

900 Hertel Ave
Buffalo, NY 14216-2611

Mailing address

900 Hertel Ave
Buffalo, NY 14216-2611
Phone (716) 871-1571

Other practice location 1

955 Main St
Buffalo, NY 14203-1121
Phone (716) 829-3466

Other practice location 2

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220929001220 NY Practitioner - Internal Medicine 2961739289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians

Practice addresses (Care Compare)

900 Hertel Ave
Buffalo, NY 14216-2611
Phone (716) 871-1571

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Sep 1, 2022 Accepting new patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Sep 1, 2022 Accepting new patients
Kaleida Health Past Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1063079648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162611",
            "telephone_number": "716-871-1571",
            "fax_number": "716-871-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162611",
            "telephone_number": "716-871-1571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031121",
            "country_code": "US",
            "telephone_number": "716-829-3466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 High St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031126",
            "country_code": "US",
            "telephone_number": "716-859-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JASMYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "316025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.